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1.
  • Algurén, Beatrix, et al. (författare)
  • A scoping review and mapping exercise comparing the content of patient-reported outcome measures (PROMs) across heart disease-specific scales
  • 2020
  • Ingår i: Journal of Patient-Reported Outcomes. - : Springer. - 2509-8020. ; 4:1
  • Forskningsöversikt (refereegranskat)abstract
    • BACKGROUND: Over the past decade, the importance of person-centered care has led to increased interest in patient-reported outcome measures (PROMs). In cardiovascular care, selecting an appropriate PROM for clinical use or research is challenging because multimorbidity is often common in patients. The aim was therefore to provide an overview of heart-disease specific PROMs and to compare the content of those outcomes using a bio-psycho-social framework of health.METHODS: A scoping review of heart disease-specific PROMs, including arrhythmia/atrial fibrillation, congenital heart disease, heart failure, ischemic heart disease, and valve diseases was conducted in PubMed (January 2018). All items contained in the disease-specific PROMs were mapped to WHO's International Classification of Functioning, Disability and Health (ICF) according to standardized linking rules.RESULTS: A total of 34 PROMs (heart diseases in general n = 5; cardiac arrhythmia n = 6; heart failure n = 14; ischemic heart disease n = 9) and 147 ICF categories were identified. ICF categories covered Body functions (n = 61), Activities & Participation (n = 69), and Environmental factors (n = 17). Most items were about experienced problems of Body functions and less often about patients' daily activities, and most PROMs were specifically developed for heart failure and no PROM were identified for valve disease or congenital heart disease.CONCLUSIONS: Our results motivate and provide information to develop comprehensive PROMs that consider activity and participation by patients with various types of heart disease.
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2.
  • Broström, Anders, 1963-, et al. (författare)
  • Undiagnosed obstructive sleep apnea in hypertensive outpatients in primary care : Associations with sleep complaints, depressive symptoms and global perceived health
  • 2013
  • Ingår i: Open Journal of Nursing. - : Scientific Research Publishing, Inc.. - 2162-5336 .- 2162-5344. ; 3:6, s. 445-452
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: 1) To describe the prevalence of undiagnosed obstructive sleep apnea (OSA) and depressive symptoms in hypertensive men and women below 65 years of age, and 2) to describe the association of OSA to subjective sleep complaints, depressive symptoms and global perceived health. Design: Cross-sectional design focusing on nursing care outcomes of obstructive sleep apnea. Setting: Four primary care health centres in Sweden. PATIENTS: 411 consecutive patients (52% women), mean age 57.9 years (SD 5.9 years), with diagnosed hypertension (BP > 140/90). Main Outcome Measures: Prevalence of OSA and depressive symptoms, and association of OSA to sleep complaints, depressive symptoms and global perceived health. RESULTS: Mild, moderate and severe OSA was seen among 29%, 16% and 14% of patients, respectively. Depressive symptoms were seen in 16% of the total group, with a higher prevalence among men, compared to women, 21% vs. 12%. No differences were found regarding blood pressure, estimated sleep need, sleep sufficiency index, insomnia symptoms, daytime sleepiness or depressive symptoms with respect to different degrees of OSA. Apnea-hypopnea index was significantly associated to perceived health after adjustment for gender and comorbidities, but when depressive symptoms and non-restorative sleep were added to the model, 33% of the variance in global perceived health was explained. Conclusion: OSA is highly prevalent among patients with hypertension in primary care and does together with sleep complaints and depressive symptoms have a negative impact on global perceived health. Hypertensive patients without subjective sleep complaints or depressive symptoms may still have OSA.
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3.
  • Broström, Anders, et al. (författare)
  • Validation of the CPAP Habit Index-5 : A Tool to Understand Adherence to CPAP Treatment in Patients with Obstructive Sleep Apnea.
  • 2014
  • Ingår i: Sleep Disorders. - : Hindawi Limited. - 2090-3545 .- 2090-3553. ; 2014
  • Tidskriftsartikel (refereegranskat)abstract
    • Long-term adherence to continuous positive airway pressure (CPAP) is low among patients with obstructive sleep apnea (OSA). The potential role of "habit" in sustaining adherence to CPAP use has not been studied. This study aimed to establish the relevance of habit to CPAP adherence, via validation of an adaptation of the Self-Report Habit Index (the CPAP Habit Index-5; CHI-5). Analyses focused on the homogeneity, reliability, and factor structure of the CHI-5 and, in line with theoretical predictions, its utility as a predictor of long-term CPAP adherence in middle-aged patients with OSA. A prospective longitudinal design was used. 117 patients with objectively verified OSA intended for CPAP treatment were recruited. Data was collected via clinical examinations, respiratory recordings, questionnaires, and CPAP devices at baseline, 2 weeks, 6 months, and 12 months. The CHI-5 showed satisfactory homogeneity interitem correlations (0.42-0.93), item-total correlations (0.58-0.91), and reliability ( α = 0.92). CHI-5 data at 6 months showed a one-factor solution and predicted 63% of variance in total CPAP use hours after 12 months. Based on the satisfactory measurement properties and the high amount of CPAP use variance it explained, the CHI-5 can be seen as a useful tool in clinical practice.
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4.
  • Eriksson, Kerstin, et al. (författare)
  • Association of pain ratings with the prediction of early physical recovery after general and orthopaedic surgery : A quantitative study with repeated measures
  • 2017
  • Ingår i: Journal of Advanced Nursing. - : Wiley-Blackwell. - 0309-2402 .- 1365-2648. ; 73:11, s. 2664-2675
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: To compare different levels of self-rated pain and determine if they predict anticipated early physical recovery in patients undergoing general and orthopaedic surgery. Background: Previous research has indicated that average self-rated pain reflects patients' ability to recover the same day. However, there is a knowledge gap about the feasibility of using average pain ratings to predict patients' physical recovery for the next day. Design: Descriptive, quantitative repeated measures. Methods: General and orthopaedic inpatients (n = 479) completed a questionnaire (October 2012-January 2015) about pain and recovery. Average pain intensity at rest and during activity was based on the Numeric Rating Scale and divided into three levels (0-3, 4-6, 7-10). Three out of five dimensions from the tool "Postoperative Recovery Profile" were used. Because few suffered severe pain, general and orthopaedic patients were analysed together. Results: Binary logistic regression analysis showed that average pain intensity postoperative day 1 significantly predicted the impact on recovery day 2, except nausea, gastrointestinal function and bladder function when pain at rest and also nausea, appetite changes, and bladder function when pain during activity. High pain ratings (NRS 7-10) demonstrated to be a better predictor for recovery compared with moderate ratings (NRS 4-6), day 2, as it significantly predicted more items in recovery. Conclusion: Pain intensity reflected general and orthopaedic patients' physical recovery postoperative day 1 and predicted recovery for day 2. By monitoring patients' pain and impact on recovery, patients' need for support becomes visible which is valuable during hospital stays.
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5.
  • Eriksson, Kerstin, et al. (författare)
  • Numeric rating scale : patients' perceptions of its use in postoperative pain assessments
  • 2014
  • Ingår i: Applied Nursing Research. - : Elsevier BV. - 0897-1897 .- 1532-8201. ; 27:1, s. 41-46
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: The purpose of this study was to describe how patients perceive the use of the numeric rating scale in postoperative pain assessments. Background: There are recommendations to use a pain scale to follow patients' postoperative pain. Most patients prefer the NRS but there is a discrepancy between patients and healthcare professionals how to interpret the ratings from the pain assessments. Methods: A descriptive design with a phenomenographic approach was used. Semi structured interviews were held with 25 patients. Results: Three description categories emerged that illustrate patients' perceptions; use of the NRS facilitated communication of pain, it put demands on healthcare professionals and care routines and it contained interpretation difficulties. Conclusion: The NRS has a place in pain management according to the patients but there is a need for a dialogue to give the patients the opportunity to describe their pain and set a common goal. (C) 2014 Elsevier Inc. All rights reserved.
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6.
  • Lin, Chung-Ying, et al. (författare)
  • Psychometric Properties of the 9-item European Heart Failure Self-care Behavior Scale Using Confirmatory Factor Analysis and Rasch Analysis Among Iranian Patients
  • 2018
  • Ingår i: Journal of Cardiovascular Nursing. - : Lippincott Williams & Wilkins. - 0889-4655 .- 1550-5049. ; 33:3, s. 281-288
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The 9-item European Heart Failure Self-Care Behavior scale (EHFScB-9) is a self-reported questionnaire commonly used to capture the self-care behavior of people with heart failure (HF). Objective: The aim of this study was to investigate the EHFScB-9's factorial structure and categorical functioning of the response scale and differential item functioning (DIF) across subpopulations in Iran. Methods: Patients with HF (n = 380; 60.5% male; mean [SD] age, 61.7 [9.1] years) participated in this study. The median (interquartile range) of the duration of their HF was 6.0 (2.4-8.8) months. Most of the participants were in New York Heart Association classification II (NYHA II, 61.8%); few of them had left ventricular ejection fraction assessment (11.3%). All participants completed the EHFScB-9. Confirmatory factor analysis was used to test the factorial structure of the EHFScB-9; Rasch analysis was used to analyze categorical functioning and DIF items across 2 characteristics (gender and NYHA). Results: The 2-factor structure ("adherence to regimen" and "consulting behavior") of the EHFSCB-9 was confirmed, and the unidimensionality of each factor was found. Categorical functioning was supported for all items. No items displayed substantial DIF across gender (DIF contrast, -0.25-0.31). Except for item 3 ("Contact doctor or nurse if legstfeet are swollen"; DIF contrast, -0.69), no items displayed substantial DIF across NYHA classes (DIF contrast, -0.40 to 0.47). Conclusions: Despite the DIF displayed in 1 item across the NYHA classes, the EHFScB-9 demonstrated sound psychometric properties in patients with HF.
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7.
  • Wikström, Lotta, et al. (författare)
  • Healthcare Professionals' Perceptions of the Use of Pain Scales in Postoperative Pain Assessments
  • 2014
  • Ingår i: Applied Nursing Research. - : Elsevier BV. - 0897-1897 .- 1532-8201. ; 27:1, s. 53-58
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: To describe how healthcare professionals perceive the use of pain scales in postoperative care. Background: Pain scales are important but not an obvious choice to use in postoperative care. No study has explored how healthcare professionals experience the use of pain scales. Methods: An explorative design with a phenomenographic approach was used. The sample consisted of 25 healthcare professionals. Semistructured interviews were performed. Results: Four descriptive categories emerged - the use of pain scales facilitated the understanding of postoperative pain, facilitated treatment, demanded a multidimensional approach and was affected by work situations. Conclusions: Healthcare professionals described that pain scales contribute to the understanding of patient's postoperative pain. It is important to ensure patient understanding and be aware about variations in pain ratings. Dialogue and observations are necessary to be certain what the ratings mean to the patient. The use of pain scales depends on patient's needs and organization. (C) 2014 Elsevier Inc. All rights reserved.
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8.
  • Wikström, Lotta, et al. (författare)
  • The clinical applicability of a daily summary of patients' self-reported postoperative pain : A repeated measure analysis
  • 2017
  • Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell. - 0962-1067 .- 1365-2702. ; 26:23-24, s. 4675-4684
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim and objectives(i) To determine whether a central tendency, median, based on patients' self-rated pain is a clinically applicable daily measure to show patients' postoperative pain on the first day after major surgery (ii) and to determine the number of self-ratings required for the calculation of this measure. BackgroundPerioperative pain traits in medical records are difficult to overview. The clinical applicability of a daily documented summarising measure of patients' self-rated pain scores is little explored. DesignA repeated measure design was carried out at three Swedish country hospitals. MethodsAssociations between the measures were analysed with nonparametric statistical methods; systematic and individual group changes were analysed separately. Measure I: pain scores at rest and activity postoperative day 1; measure II: retrospective average pain from postoperative day 1. ResultsThe sample consisted of 190 general surgery patients and 289 orthopaedic surgery patients with a mean age of 65; 56% were men. Forty-four percent had a pre-operative daily intake of analgesia, and 77% used postoperative opioids. A range of 49 pain scores seem to be eligible for the calculation of the daily measures of pain. Rank correlations for individual median scores, based on four ratings, vs. retrospective self-rated average pain, were moderate and strengthened with increased numbers of ratings. A systematic group change towards a higher level of reported retrospective pain was significant. ConclusionsThe median values were clinically applicable daily measures. The risk of obtaining a higher value than was recalled by patients seemed to be low. Applicability increased with increased frequency of self-rated pain scores and with high-quality pain assessments. Relevance to clinical practiceThe documenting of daily median pain scores at rest and during activity could constitute the basis for obtaining patients' experiences by showing their pain severity trajectories. The measures could also be an important key to predicting postoperative health-related consequences.
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